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The question was submitted 06/04/2008

Subject: Illnesses and similar traits

I have been diagnosed with depression, anxiety, ocd habits/self harming tendencies, narcisstic tendencies, eating disorder and the latest one by an independent psychiatrist is bdp.

I have got information about all of them off the sane site and they are all similar in the traits you have when you get them.

What I want to know is how do I know which is the one that is illnesses are affecting me the most given the traits of all the illnesses are the same/similar. How is a psychiatrist able to diagnose what illness you have if you have bits of various illnesses because you have bits of the same sorts of traits in each illness.

I have been talking to my psychiatrist about this and am getting some information about my illnesses/which one is the strongest illness/all the traits being the same for each illness I have been diagnnosed with but I would like more information if possible about my illnesses/similar traits of all the illnesses.

Thanks

Answer from DepNet

I'm a little unclear if you are referring to Bipolar Disorder or Borderline Personality Disorder when you use the term 'bpd'. The use of this abbreviation is potentially confusing.


Based on your reported symptoms, I would be guessing that the psychiatrist diagnosed you with Borderline Personality Disorder, rather than Bipolar Disorder.


It is quite possible to have more than one disorder diagnosed. For example, it is quite common for individuals to have a Borderline Personality Disorder and at various stages of their lives be diagnosed with Eating Disorders, Major Depressive Disorder or Substance Use Disorders. In complex cases such as these, the psychiatrist's role is to take a history of all of the symptoms / problems and try to organise these into meaningful diagnoses. Whilst some of the symptoms may look similar, in clinical practice, there may be obvious differences. For example, the type of appetite disturbance found in Major Depressive Disorder is different to that found in Anorexia Nervosa.


I think it's reasonable to ask a psychiatrist on what basis they have diagnosed you with a given condition or a given set of conditions. It is likely that the answer you get will be based on information from a diagnostic manual (e.g. DSM-IV).


In terms of what conditions affect you the most, that will depend on the diagnostic assessment conducted by your psychiatrist. Also, the relative contributions of each diagnosis may vary over time.


One thing to be aware of it that many health professionals, including psychiatrists, community mental health workers, GPs and psychologists, are reluctant to diagnose individuals with Borderline Personality Disorder, or to provide this diagnosis to the patient. This is in part because Borderline Personality Disorder is associated with stigma.

The answer was published on DepNet 07/04/2008